If you are applying by the OPM Form 1203-FX, leave this section blank.

24. Personal Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

25. Occupational/Assessment Questions:

ELIGIBILITY: The following section is used to determine your eligibility for appointment in the Federal Government. FAILURE TO RESPOND TO THESE QUESTIONS MAY RESULT IN AN INELIGIBLE RATING. Please choose A (Yes) or B (No) for each of the following items to identify which of the following descriptions applies to you.

For each task in the following group, choose response below that best describes your experience and/or training. Darken the oval corresponding to that statement in Section 25 of the Qualifications and Availability Form C. Please select only one letter for each item.

1. I am a Citizen of the United States.

A. Yes.B. No.

2. I have earned a doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA). The specialty area of the degree must be consistent with the assignment for which to be employed.

A. Yes.B. No.

3. I have successfully completed a professional psychology internship training program that has been accredited by American Psychological Association (APA) or am covered by one of the following exceptions. Exceptions: 1) new VHA pscyhooogy internship programs that are in the process of apply for APA accreditation are acceptable in fulfillment of the internship requirement, provided that such programs were sanctioned by the VHA Central Office Program Director for Psychology and the VHA Central Office of Academic Affiliations at the time that the individual was an intern and 2) VHA facilities who offered full one-year pre-doctoral internships prior to PL 96-151 (pre-1979) are considered to be acceptable in fulfillment of the internship requirement.

A. Yes.B. No.

4. I hold a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia. (Exception. The Secretary may waive the requirement of licensure for an individual psychologist for a period not to exceed 2 years from the date of employment on the condition that such a psychologist provide care only under the supervision of a psychologist who is so licensed.)

A. Yes.B. No.

5. I am proficient in spoken and written English. (To be appointed under authority of 38 U.S.C., chapter 73 or 74, to serve in a direct patient-care capacity in VHA, applicants must be proficient in written and spoken English.)

A. Yes.B. No.

6. I am a current employee of the John J. Pershing VAMC.

A. Yes.B. No.

7. Your rating is subject to verification based on the résumé, narratives and other relevant documents you submit, and through verification of references as appropriate. Deliberate attempts to falsify information are grounds for non-selection and for termination. In addition, falsifying information on your application can result in your being barred from federal employment. Please choose A to certify that your answers are accurate and complete.

A. I certify that my answers are accurate and complete. B. I do not wish to certify. I understand that I will not be considered for this position.